TN among 6 states tipped to achieve infant mortality goal

CHENNAI: Only six states across the country are likely to achieve the Millennium Development Goal (MDG) 4 of reducing under-five mortality rate by 2015. The MDG aims to reduce under-five mortality (U5MR) rate by two thirds between 1990 and 2015 and in numerical terms around 39 per 1,000.

India as a whole may fall short of realising the goal, though Maharashtra, Tamil Nadu, Karnataka, Kerala, Punjab and Himachal Pradesh will cross the milestone, said a study conducted jointly by the Unicef, the National Institute of Medical Sciences and the Indian Council of Medical Research. An analysis of data from the Sample Registration System (1978-2010) and three rounds of National Family Health Surveys conducted in 1992-93, 1998-99 and 2005-06 indicates that following the rapid decline in the 1970s, U5MR stagnated in the 1990s and then started declining again in the past decade. It fell to a level of 118 in 1990 to 93 in 2000 and 59 in 2009. Though U5MR has always been lower in urban than in rural areas, the decline in urban areas has been slower than in rural areas in the past two decades.

The report further said the 11th plan target was to reduce the infant mortality rate to 28 per 1,000 by 2012. But India is not likely to achieve this target in 2012 or even in 2016. Even among the six states, only Tamil Nadu and Kerala are likely to achieve this target in 2012, while Maharashtra may come close to achieving the target. For U5MR, the target set was 39 per 1,000 at the end of 2012. While economic status was found to have a strong and significant association with child survival, the fact is that progress in child survival in India has been equitable.

"A renewed focus on empowering women and promoting equity in access to health services will help guide actions for accelerating child survival in India, as we move towards the year 2015 and beyond," said Louis-Georges Arsenault, Unicef India representative. "We require a comprehensive approach that includes coverage of key child survival interventions, improving quality of prenatal care, promoting education of girls beyond primary, delaying the age of marriage and childbirth and ensuring adequate spacing between births," he said.

In terms of environmental determinants, the study suggests that children living in households with access to unsafe source of drinking water were at greater risk of death. Neonatal, post-neonatal and child mortality is also higher for children in households that do not have access to a flush or pit toilet.